Numerical investigation of chemically reacting jet flow of hybrid nanofluid under the significances of bio-active mixers and chemical reaction.

Jet flows are employed in a variety of applications. It can be found in daily life as well as in agriculture, for example, jet flow assists with irrigation and harvest protection. The current problem is related to the study of energy and mass transference on the hybrid nanoliquid flow with mixed convection effect due to the vertical stretching surface conveying the cobalt ferrite CoFe2O4 and titanium dioxide TiO2 nanoparticles (NPs) with the base fluid water H2O. Further, the role of the chemical reaction, heat source/sink, and activation energy are investigated. By exploiting the idea of the modified Buongiorno model, the thermophoretic and Brownian diffusivity effects have discoursed on the existing flow behavior. The existing mathematical problem is framed with the application of the nonlinear higher-order PDEs. Higher-order PDEs of the mathematical model are changed into highly nonlinear ODEs by using the concepts of suitable similarity transformations. The modified higher-order nonlinear ODEs are cracked by manipulating the bvp4c technique in MATLAB. The impacts of the numerous physical flow parameters on the velocity, energy, and concentration are computed in graphical forms. Key findings from the present problem revealed that the velocity of the nanoliquid and hybrid nanofluid decreased due to greater nanoparticles volume fraction. Furthermore, the heat transportation is greater for mixed convection and thermophoresis parameter.

Analysis of the Time-Dependent magnetohydrodynamic Newtonian fluid flow over a rotating sphere with thermal radiation and chemical reaction.

This article presents the magnetohydrodynamic (MHD) flow of a nanoliquid due to a rotating sphere at a stagnation point. The flow is considered to be influenced by the magnetic field, dissipative, thermally radiative, and chemically reactive. Also, the thermophoretic and Brownian motion influences are taken into consideration. Some restrictions in the present analysis are taken: like there is no-slip and convective conditions, joule heating, Hall effects and buoyancy-driven. The solution of the present analysis is derived through the homotopy analysis method (HAM). The significance of several physical parameters on velocities, thermal and concentration profiles are shown with the help of Figures. Also, the significance of different physical factors on skin frictions, local Nusselt number and Sherwood number are demonstrated with the help of Tables. The outcomes show that the Nusselt number is lower for the larger Brownian motion parameter, Eckert number, and thermophoretic parameter, while the increment in the thermal radiation parameter augmented the Nusselt number. It is established that the increasing rotation, magnetic and positive constant parameters have increased the velocity profiles along the x-direction while reducing the velocity profiles along the z-direction of the nanoliquid flow. The increasing positive constant parameter reduces the thermal graph of the nanoliquid flow. Furthermore, the intensifying Eckert number, thermophoresis, Brownian motion, and thermal radiation factor have escalated the thermal profiles of the nanoliquid flow.

A stratified flow of a non-Newtonian Casson fluid comprising microorganisms on a stretching sheet with activation energy.

A stratified flow may be seen regularly in a number of significant industrial operations. For instance, the stratified flow regime is typically used by gas-condensate pipelines. Clearly, only a limited set of working situations for which this flow arrangement is stable allow for the achievement of the stratified two-phase flow zone. In this paper, the authors are considered the laminar, steady and incompressible magnetohydrodynamic flow of a non-Newtonian Casson fluid flow past a stratified extending sheet. The features of bio-convection, Brownian motion, thermal radiation thermophoresis, heat source, and chemically reactive activation energy have been employed. The set of equations administered flow of fluid is converted into ordinary differential equation by suitable variables. A semi-analytical investigation of the present analysis is performed with homotopy analysis method. Endorsement of the current results with previous results is also investigated. The outcomes showed that the velocity distribution of the fluid flow lessens with higher Casson and magnetic factors. The temperature profiles of fluid flow shrinkage as the Prandtl number and Casson factor increase and enlarges with higher values of thermal radiation, magnetic, and Brownian motion factors. It is found that the growing thermophoretic and Brownian motion factors reduce the rate of thermal flow of the Casson fluid flow. In contrast, the increasing thermal stratification parameter increases the thermal flow rate of fluid.

A comparative analysis of the time-dependent magnetized blood-based nanofluids flows over a stretching cylinder.

This article explores the analysis of magnetized blood-based nanofluids flows over an extending cylinder. The nanofluid contains copper, copper oxide and iron oxide nanoparticles which are mixed with blood. The mathematical model has been built-up in partial differential equations (PDEs) form and then changed into ordinary different equations by mean of suitable similarity variables and then has been evaluated by homotopy analysis method (HAM). The convergence of the applied technique is presented in graphical form. During the solution process, the influences of physical parameters like magnetic parameter, unsteadiness parameter, curvature parameter and thermal relaxation time parameter on the flow profiles have been investigated and depicted in Figures and Tables. The correctness of the present model has also been presented in tabular form. The results show that the greater curvature factor reduces the radius of cylinder due to which thickness of layer becomes thin at the boundaries and therefore the velocity distribution declines, while the greater curvature parameter has the increasing impact on the temperature distribution for constant wall temperature (CWT) case and decreases the temperature distribution for prescribed surface temperature (PST) case.

Transient Osteoporosis of the Hip: A Radiologist's Perspective.

Transient osteoporosis of the hip (TOOH) is a rare disorder of unknown etiology without any antecedent history of trauma. There is a sudden onset of acute severe pain and temporary osteopenia in the joint involved with associated radiological findings of bone loss and marrow edema. Magnetic Resonance Imaging (MRI) is the gold standard imaging modality for diagnosis and disease monitoring. The major goal of this case presentation is to emphasize the necessity to add TOOH as an important differential of sudden hip pain and to review the literature on this entity.

MIMO Antenna System for Modern 5G Handheld Devices with Healthcare and High Rate Delivery.

In this work, a new prototype of the eight-element MIMO antenna system for 5G communications, internet of things, and networks has been proposed. This system is based on an H-shaped monopole antenna system that offers 200 MHz bandwidth ranges between 3.4-3.6 GHz, and the isolation between any two elements is well below -12 dB without using any decoupling structure. The proposed system is designed on a commercially available 0.8 mm-thick FR4 substrate. One side of the chassis is used to place the radiating elements, while the copper from the other side is being removed to avoid short-circuiting with other components and devices. This also enables space for other systems, sub-systems, and components. A prototype is fabricated and excellent agreement is observed between the experimental and the computed results. It was found that ECC is 0.2 for any two radiating elements which is consistent with the desirable standards, and channel capacity is 38 bps/Hz which is 2.9 times higher than 4 × 4 MIMO configuration. In addition, single hand mode and dual hand mode analysis are conducted to understand the operation of the system under such operations and to identify losses and/or changes in the key performance parameters. Based on the results, the proposed antenna system will find its applications in modern 5G handheld devices and internet of things with healthcare and high rate delivery. Besides that, its design simplicity will make it applicable for mass production to be used in industrial demands.

Implementation of lung cancer screening in Europe: challenges and potential solutions: summary of a multidisciplinary roundtable discussion.

Recent randomised trials on screening with low-dose CT have shown important reductions in lung cancer (LC) mortality and have triggered international efforts to implement LC screening. Detection rates of stage I LC with volume CT approaching 70% have been demonstrated. In April 2019 'ESMO Open - Cancer Horizons' convened a roundtable discussion on the challenges and potential solutions regarding the implementation of LC screening in Europe. The expert panel reviewed the current evidence for LC screening with low-dose CT and discussed the next steps, which are covered in this article. The panel concluded that national health policy groups in Europe should start to implement CT screening as adequate evidence is available. It was recognised that there are opportunities to improve the screening process through 'Implementation Research Programmes'.

Rehabilitation, the Great Absentee of Virtual Coaching in Medical Care: Scoping Review.

BACKGROUND: In the last few years, several studies have focused on describing and understanding how virtual coaches (ie, coaching program or smart device aiming to provide coaching support through a variety of application contexts) could be key drivers for health promotion in home care settings. As there has been enormous technological progress in the field of artificial intelligence and data processing in the past decade, the use of virtual coaches gains an augmented attention in the considerations of medical innovations. OBJECTIVE: This scoping review aimed at providing an overview of the applications of a virtual coach in the clinical field. In particular, the review focused on the papers that provide tangible information for coaching activities with an active implication for engaging and guiding patients who have an ongoing plan of care. METHODS: We aimed to investigate the use of the term virtual coach in the clinical field performing a methodical review of the relevant literature indexed on PubMed, Scopus, and Embase databases to find virtual coach papers focused on specific activities dealing with clinical or medical contexts, excluding those aimed at surgical settings or electronic learning purposes. RESULTS: After a careful revision of the inclusion and exclusion criteria, 46 records were selected for the full-text review. Most of the identified articles directly or indirectly addressed the topic of physical activity. Some papers were focused on the use of virtual coaching (VC) to manage overweight or nutritional issues. Other papers dealt with technological interfaces to facilitate interactions with patients suffering from different chronic clinical conditions such as heart failure, chronic obstructive pulmonary disease, depression, and chronic pain. CONCLUSIONS: Although physical activity is a healthy practice that is most encouraged by a virtual coach system, in the current scenario, rehabilitation is the great absentee. This paper gives an overview of the tangible applications of this tool in the medical field and may inspire new ideas for future research on VC.

Physiological Uptake of F18-FDG in breast parenchyma.

Increased F18-FDG uptake is on PET-CT images should always be assessed carefully for physiological and pathological causes. Breast uptake may be focal or diffuse. Although propensity of tumours increase in focal uptake; diffuse involvement may be seen in lymphoma and some types of breast cancer. Frequently, diffuse breast uptake is non-pathologic due to infection, physiological uptake or lactation. We describe the case of a 27-years old female who underwent 18F FDGPET-CT scan for staging workup of diffuse large B-cell lymphoma (DLBCL). The scan demonstrated bilateral F18-FDG breast uptake, due to ongoing lactation.

Ollier's Disease with Myelodysplastic Syndrome.

Ollier's disease also known as enchondromatosis is a rare skeletal disorder that is usually sporadic, non-hereditary, and characterized by abnormal bone development (skeletal dysplasia). While this disorder may be present at birth (congenital); it may not become apparent until early childhood with more obvious symptoms, such as deformities or improper limb growth. It carries high risk of skeletal, visceral and brain malignancy seen in approximately 25% of patients. Occurrence of Ollier's disease with myelodysplastic syndrome has never been reported in the literature. The different types of myelodysplastic syndromes are diagnosed based on certain changes in the blood cells and bone marrow characterized by one or more cytopenias despite a relatively hypercellular bone marrow. We hereby report the case of a 14 years boy who presented with painless finger swelling and hepatosplenomegaly. Radiological and bone marrow findings confirmed the diagnosis of Ollier's disease with Refractory Anemia and Excess Blasts (RAEB-1).

EFFECT OF EPIDURAL ANALGESIA ON LABOR AND ITS OUTCOMES.

BACKGROUND: Epidural analgesia is an effective and popular way to relieve labour pain but it may interfere with normal mechanism of labour. The objective of this study was to evaluate the outcome of labour in women with effective epidural analgesia in terms of duration of labour, mode of delivery and neonatal outcome. METHODS: This was a quasi-experimental study conducted in the Department of Obstetrics and Gynaecology, Shaikh Zayed Federal Postgraduate Medical Institute and Hospital, Lahore. One hundred pregnant women were selected by non-probability convenient sampling method. Subjects were divided into two groups of. 50 each as per convenience. Patients of any gravidity at term from 37-41 weeks were included in the sample. Epidural analgesia was applied to group B and distilled water to group A at the lumber region and the progress of labour, mode of delivery and effects on Apgar scores of neonates were evaluated. Out of hundred patients, 77 had normal duration of second stage while 23 had prolonged second stage. Among them, 18 patients (36%) were in epidural group and 5 patients (10%) in non-epidural group, while 4 patients (8%) in epidural group developed intra-partum complications; whereas among non-epidural group had such complications. 65 patients had spontaneous vaginal delivery while 35 patients had instrumental delivery. Among them 29 patients (58%) were in epidural group while only 6 patients (12%) were in non-epidural group. Babies born had Apgar score 5/10 (21.8%), 6/10 (59.4%) and 7/10 (17.8%) at 1 minute and 8/10 (74.3%) and 9/10 (24.8%) at 5 minutes in both groups and none of them needed bag and mask resuscitation. CONCLUSION: Epidural analgesia does prolong the duration of second stage of labour and increases the instrumental delivery rate. Neonatal outcome is satisfactory while only a few intra-partum complications are found with epidural analgesia.

CLINICO-PATHOLOGICAL PATTERN, CLASSIFICATION AND STAGING OF URINARY BLADDER CARCINOMAS--A FIVE YEARS EXPERIENCE AT A TERTIARY CARE HOSPITAL IN CENTRAL PUNJAB. .

BACKGROUND: In Pakistan, urinary bladder carcinoma is the 8th commonest malignancy while being the fourth commonest cancer in men. The relative occurrence of a particular histological type of bladder carcinoma depends on the clinical setting. Both grade and stage of these cancers are highly correlated with recurrence, progression and patient survival rates. METHODS: This cross- sectional study comprised of 122 patients with newly diagnosed operable primary bladder carcinomas who underwent cystoscopy associated transurethral resection of bladder tumour at the Urology Department of Punjab Employees Social Security Hospital, Lahore. All participants completed a detailed questionnaire and underwent an in-depth interview to obtain data. The surgical specimens were referred to the Pathology department. Gross observations of the tumour recorded. RESULT: A total of 114 cases, classified according to WHO/ISUP criteria, low-grade papillary lesions, comprising Papillary Urothelial Neoplasm of Low Malignant Potential (PUNLMP) and Papillary Low Grade carcinomas, accounted for 43% of tumours. Male to female ratio being 5.3:1 (74%). Lateral walls were involved in 44%, posterior wall in 25.3%, trigone in 10.7%, bladder neck in 7.2%, dome in 5.8%, ureteric orifice in 4.13%, anterior wall in 2% and left ureter in 0.87% cases. Tumour staging revealed an overall 11.5% of tumours with stage Ta and 31.5% with stage T3-4. About 29% tumours were non invasive. About n=13 of low-grade carcinomas and n=68 of high-grade carcinomas were invasive. For tumours classified by WHO/ISUP criteria, the percentage of women was larger for PUNLMP than for the other categories of urothelial tumours (p-value 0.006); no statistically significant difference was found by age or gender with respect to tumour stage (p-value 0.138 and 0.452). CONCLUSION: Transitional Cell Carcinoma (TCC) is the commonest among middle aged men.

Intrarenal neuroblastoma: a diagnostic challenge.

Abdominal masses in children are usually retroperitoneal in location and 50% are renal in origin. In infants less than 2 months, majority of renal masses are benign; frequency of malignancy increases with age. Wilms'tumor is the commonest solid intrarenal tumors. However, occasionally neuroblastoma occurs in the kidney. Neuroblastoma in 50% of cases presents before 2 years of age, and 75% before 4 years. Neuroblastomas can occur anywhere along the neuroectodermal sympathetic chain, although adrenal medulla is the commonest site (50 - 70%). Intrarenal neuroblastoma is a rare clinical diagnosis. It clinically and radiologically mimics Wilms'tumor and it is difficult to differentiate between the two preoperatively. Lung metastasis and vascular invasion are also rare in neuroblastoma but rather common in Wilms'tumor. We present case of a patient who had extensive renal involvement with neuroblastoma and pulmonary metastasis, clinically and radiologically it was difficult to differentiate between the Wilms'tumor and neuroblastoma.

What characteristics of primary care and patients are associated with early death in patients with lung cancer in the UK?

BACKGROUND: The UK has poor lung cancer survival rates and high early mortality, compared to other countries. We aimed to identify factors associated with early death, and features of primary care that might contribute to late diagnosis. METHODS: All cases of lung cancer diagnosed between 2000 and 2013 were extracted from The Health Improvement Network database. Patients who died within 90 days of diagnosis were compared with those who survived longer. Standardised chest X-ray (CXR) and lung cancer rates were calculated for each practice. RESULTS: Of 20,142 people with lung cancer, those who died early consulted with primary care more frequently prediagnosis. Individual factors associated with early death were male sex (OR 1.17; 95% CI 1.10 to 1.24), current smoking (OR 1.43; 95% CI 1.28 to 1.61), increasing age (OR 1.80; 95% CI 1.62 to 1.99 for age ≥80 years compared to 65-69 years), social deprivation (OR 1.16; 95% CI 1.04 to 1.30 for Townsend quintile 5 vs 1) and rural versus urban residence (OR 1.22; 95% CI 1.06 to 1.41). CXR rates varied widely, and the odds of early death were highest in the practices which requested more CXRs. Lung cancer incidence at practice level did not affect early deaths. CONCLUSIONS: Patients who die early from lung cancer are interacting with primary care prediagnosis, suggesting potentially missed opportunities to identify them earlier. A general increase in CXR requests may not improve survival; rather, a more timely and appropriate targeting of this investigation using risk assessment tools needs further assessment.

Brain metastases following radical surgical treatment of non-small cell lung cancer: is preoperative brain imaging important?

OBJECTIVES: There is a lack of good quality evidence or a clear consensus of opinion internationally regarding who should receive preoperative imaging of the brain prior to radical treatment for non-small cell lung cancer (NSCLC). We aimed to establish the proportion of patients who developed brain metastases following curative surgery and to estimate how many could have been detected by preoperative magnetic resonance imaging (MR). METHODS: We performed a retrospective analysis of 646 patients who underwent surgery for lung cancer with curative intent at a regional thoracic surgical centre in the United Kingdom. We identified those who developed brain metastases in the postoperative period and, by using volume doubling times, estimated the size of the metastasis at the time of surgery. We then determined the proportion of metastases that would have been seen on preoperative MR brain at detection thresholds of 2 and 5mm diameter. RESULTS: There was a 6.3% incidence of postoperative brain metastases, with the majority occurring within 12 months of surgery. Those who developed metastases were more likely to have adenocarcinoma and the majority had early stage malignancy (73% stage I or stage II). We estimate that 71% of those who developed cerebral metastases might have been detected had they undergone MR brain as part of their staging (4.4% of all patients). CONCLUSION: Based on our findings we suggest that, in addition to standard staging investigations, patients have brain imaging (MR or equivalent) prior to curative surgery in NSCLC regardless of preoperative stage.

Primary renal Ewing's sarcoma: a rare entity.

Ewing's sarcoma, a primitive neuroectodermal tumour is a rare entity belonging to a family of neoplasms of neuroectodermal origin. These highly aggressive neoplasms primarily affect older children and young adults. They primarily involve the bones or soft tissues. A quarter of Ewing's sarcomas occur principally in the soft tissues with primary involvement of the kidney being exceptionally rare. We hereby, present a case of 6 years old girl child with primary Ewing's sarcoma of the kidney who presented with abdominal mass and posed much diagnostic challenge. The patient underwent complete surgical excision of tumour, and is being treated with aggressive adjuvant chemotherapy.

Staphylococcus aureus induces eosinophil cell death mediated by α-hemolysin.

Staphylococcus aureus, a major human pathogen, exacerbates allergic disorders, including atopic dermatitis, nasal polyps and asthma, which are characterized by tissue eosinophilia. Eosinophils, via their destructive granule contents, can cause significant tissue damage, resulting in inflammation and further recruitment of inflammatory cells. We hypothesised that the relationship between S. aureus and eosinophils may contribute to disease pathology. We found that supernatants from S. aureus (SH1000 strain) cultures cause rapid and profound eosinophil necrosis, resulting in dramatic cell loss within 2 hours. This is in marked contrast to neutrophil granulocytes where no significant cell death was observed (at equivalent dilutions). Supernatants prepared from a strain deficient in the accessory gene regulator (agr) that produces reduced levels of many important virulence factors, including the abundantly produced α-hemolysin (Hla), failed to induce eosinophil death. The role of Hla in mediating eosinophil death was investigated using both an Hla deficient SH1000-modified strain, which did not induce eosinophil death, and purified Hla, which induced concentration-dependent eosinophil death via both apoptosis and necrosis. We conclude that S. aureus Hla induces aberrant eosinophil cell death in vitro and that this may increase tissue injury in allergic disease.

Assisted breech delivery with transverse vaginal septum.

The incidence of vaginal septum is rare. The infrequency of this anomaly makes accurate estimates of the true incidence very difficult to obtain. Diagnosis is based on careful historyand examination. This is the case of a patient who presented with transverse vaginal septum in labour and breech presentation. The septum was resected and the foetus delivered normally. Careful vaginal examination should be performed in pregnant women at term before labour to detect such manageable abnormalities.

Vesicovaginal and rectovaginal fistulas: 12-year results of surgical treatment.

BACKGROUND: Although the magnitude of obstetric fistulae (OF) is reported to have decreased in industrialised countries, it is still a major problem in developing countries especially the fistulae resulting from obstructed labour. Vesico-vaginal fistulae (VVF) are the most common and the most frequent type of urogenital fistulas. In most cases, surgery is required for treatment. The aim of this study was to analyse the results of surgical treatment of VVF and Rectovaginal Fistulae (RVF) in a tertiary level institution over 12 years period. METHODS: This retrospective study was conducted at Ayub Teaching Hospital, and Women and Children Hospital, Abbottabad. It included records of a total of 74 patients who were surgically treated from 2001 to 2012. RESULTS: Cause of VVF was obstructed labour in 81.08% of cases, and it was iatrogenic in 18.92% cases. In the surgical treatment of primary VVF transvaginal approach was used in 91.9%, while transabdomenal approach was used in 2.7% cases. In 54.1% of cases the VVF healed after a single surgical intervention, while in 45.9% cases more-than-one operations were required. CONCLUSION: Birth trauma is still a major cause of VVF/RVF in our region. Prevention is possible with provision of sufficient health care and public awareness. Successful repair is possible with 1st surgery.